Infection Control

Are alcohol wipes effective in

the presence of protein?
Dr Tim Sandle reports on a new study that examines the microcidal efficacy of
alcohol based wipes on a variety of protein contaminated dental surfaces.

Dr Tim Sandle
is site microbiologist at Bio Products
Laboratory and a visiting tutor
with the School of Pharmacy and
Pharmaceutical Sciences, University
of Manchester.
92 The Dentist October 2014

nfection control is an integral part

of dental practice, particularly in
ensuring that surfaces are clean and
potentially pathogenic microorganisms,
including the bacteria that cause
tuberculosis and MRSA infections are
eliminated.
HTM 05-01 6.61 recommends that:
The patient treatment area should
be cleaned after every session using
disposable cloths or clean microfibre
materials even if the area appears
uncontaminated.
Surfaces should be wiped down

between patients with a high quality

disinfectant. Wipes pre-saturated with
the disinfectant of choice are usually
the preferred format in a busy dental
practice as they are convenient to use,
disposable and require less storage
space than sprays. An ideal disinfectant
should have a high inactivating
capacity for a wide range of viruses,
including HIV and hepatitis, as well
as being effective against bacteria,
including tuberculosis. It should be
safe to use and suitable for frequent
application.

Infection Control

Research suggests that alcohol wipes

are capable of destroying the widest
range of microbial contamination
(including Mycobacteria, the genus of
bacteria that includes the infectious
cause of tuberculosis). Alcohol wipes
are virucidal against enveloped
viruses, such as HIV and hepatitis
B and against the non-enveloped
viruses, such as poliovirus, rhinoviruses
and hepatitis A.
However, in addition to microbial
contamination, surfaces may also be
contaminated with protein residues
such as blood and pus. It has been
suggested that alcohol may bind
protein to stainless surfaces and the
presence of protein may compromise
the efficacy of alcohol based wipes.
To test the protein binding hypothesis,
a study was performed in conditions
to simulate those found in a dental
practice. Alcohol wipes were tested on
three surfaces including stainless steel
against the microorganisms commonly
found in dental surgeries, in the
presence of protein residues.
This article examines the design
and results of the study; and assesses
the implications for practices when
selecting a disinfectant wipe.
Study design
The selection of microorganisms and
surfaces was designed to simulate the
types of pathogens, protein residues
and conditions that are likely to be
found in a typical dental practice.
The test method was based on an
internationally recognised standard for
the evaluation of disinfectant wipes on
hard surfaces.
Mikrozid alcohol based wipes were
tested for their ability to destroy or
remove a range of microorganisms
from three different surfaces - formica,
stainless steel and laminate. The
microorganisms assessed were:
Staphylococcus aureus (which is linked
to MRSA infection), a Mycobacterium
with similar properties to tuberculosis,
a microorganism commonly associated
with water system contamination,
and the yeast that causes thrush. The
population of each microorganism
used was sufficient to measure
that up to 1000-times kill of the
microorganism had been achieved. The
microorganisms were sourced from an
approved culture collection.
94 The Dentist October 2014

To simulate the effect of potential

protein fixation, a pure protein was
used (albumin), with each surface
containing three percent protein
contamination. The test panel of
microorganisms was inoculated onto
samples of the three different surfaces,
in a laboratory and allowed to dry.
The surfaces were then doublewiped with the alcohol based wipes.
Each surface was left for one minute
to allow the disinfectant to penetrate
the microorganisms. The action of
the alcohol based wipe was then
measured.
To ensure the robustness of the study,
10 carriers were used for each test.
Each microorganism was tested on
three occasions to demonstrate that the
test was reproducible.
Study results
The results of the study demonstrated
that alcohol based wipes achieved a
three-log reduction in the microbial
challenge, in the presence of pure
protein residue. No protein fixation was
observed at any stage of the study.
A summary of the test outcomes for
the alcohol wipes is shown in table 1.
Conclusion
The study demonstrated that Mikrozid
alcohol based wipes are effective
in eliminating a range of different
microorganisms from surfaces, in the
presence of protein residue. In practice,

the correct use of the wipes should

be followed using a double wiping
technique and the disinfectant should
remain in contact with all surfaces for
one minute.
Dental practices can therefore use
alcohol-based wipes with confidence
for hard surface cleaning when the
most effective spectrum of disinfectant
activity is required, including all hard
surfaces contaminated with protein
residues.
References available on request.

Microorganism
Surface

Dirty conditions
protein residue

Mycobacterium terrae
(ATCC 35741)

Formica
Pass
Stainless steel
Pass
Laminate Pass

Candida albicans
(ATCC 10231)

Formica
Pass
Stainless steel
Pass
Laminate Pass

Pseudomonas
aeruginosa
(ATCC 9027)

Formica
Stainless steel
Laminate

Staphylococcus aureus
(ATCC 6538)

Formica
Pass
Stainless steel
Pass
Laminate Pass

Pass
Pass
Pass

Table 1: Table showing the outcomes from the test on the Mikrozid alcohol wipes using four
microorganisms and three surface types, examined under dirty (protein soiled) conditions. The
challenge population was >1 x 103 for each microorganism.